De Schepper A M, Ramon F A, Degryse H R
Department of Radiology, Antwerp University Hospital, Edegem, Belgium.
Rofo. 1992 Jun;156(6):587-91. doi: 10.1055/s-2008-1032948.
Since well-known grading parameters such as cellularity, mitotic rate, matrix and presence of necrosis all influence MRI signal intensity, the value of MRI in predicting malignancy is potentially high. To assess this value we studied retrospectively the findings in 141 soft tissue tumours (84 benign, 57 malignant) and evaluated a wide variety of MRI features (size, margins, signal homogeneity, shape, signal intensity, neurovascular and bone involvement, degree and pattern of enhancement and evidence of necrosis after injection of Gd-DTPA). Statistical analysis was carried out to determine accuracy of parameters individually and in combination, for predicting malignancy. Highest sensitivity was obtained for "absence of low signal intensity on T2" (100%), "mean diameter greater than 33 mm" (90%), and "inhomogeneous signal on T1" (88%). Highest specificity was obtained for "evidence of necrosis" (98%), "bone or neurovascular involvement or metastases" (94%), and "mean diameter greater than 66 mm" (87%). Association of best sensitivity and specificity was seen for "absence of low signal intensity on T2", "signal inhomogeneity on T1", and "mean diameter of the lesion greater than 33 mm" (81 and 81%).
由于细胞密度、有丝分裂率、基质和坏死情况等知名分级参数都会影响MRI信号强度，因此MRI在预测恶性肿瘤方面具有很高的潜在价值。为了评估这一价值，我们回顾性研究了141例软组织肿瘤（84例良性，57例恶性）的检查结果，并评估了多种MRI特征（大小、边缘、信号均匀性、形状、信号强度、神经血管和骨骼受累情况、增强程度和方式以及注射钆喷替酸葡甲胺后的坏死证据）。进行统计分析以确定各参数单独及联合预测恶性肿瘤的准确性。“T2加权像上无低信号”（100%）、“平均直径大于33mm”（90%）和“T1加权像信号不均匀”（88%）的敏感性最高。“有坏死证据”（98%）、“骨骼或神经血管受累或转移”（94%）和“平均直径大于66mm”（87%）的特异性最高。“T2加权像上无低信号”、“T1加权像信号不均匀”和“病变平均直径大于33mm”的敏感性和特异性最佳组合为81%和81%。
